Individual
CORETTA LUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
829 SCOTT RD, RIVERDALE, GA 30296
(678) 469-8616
(770) 997-7567
Mailing address
829 SCOTT RD, RIVERDALE, GA 30296
(678) 469-8616
(770) 997-7567
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN187224
GA
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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